Chest
Original ResearchObstructive Lung DiseasesValidation of a Novel Risk Score for Severity of Illness in Acute Exacerbations of COPD
Section snippets
Data Source
We used one of the clinical research databases from CareFusion (Clinical Research Services, CareFusion; Marlborough, Massachusetts) for the period from January 1, 2007, through December 31, 2007. This database records input from 177 hospitals on all acutecare admissions. Specifically, the database contains information concerning patient demographics, discharge diagnoses, length of stay, hospital charges, and hospital mortality. It also includes patient vital signs and results from laboratory
Results
The final cohort included 34,669 subjects, of whom 80.6% had a principal diagnosis of AECOPD and the remainder had acute respiratory failure noted as the principal diagnosis along with COPD as a secondary diagnosis. As shown in Table 1, the median age was 72 years and 46.4% were men. The most common comorbidities were hypertension, congestive heart failure, and diabetes mellitus.
Approximately 4% of patients died while in the hospital, and MV was required at any point in 9.2%. We observed the
Discussion
This analysis of a large cohort of patients with AECOPDs demonstrates that the BAP-65 class correlates well with multiple clinical outcomes ranging from in-hospital mortality and need for MV to LOS and cost. Furthermore, the BAP-65 system identifies subjects unlikely to ever need MV. Given that clinical decision making along with determinations as to the triage of patients is a complex process that requires an analysis of multiple factors beyond just severity of illness, the ability of BAP-65
Acknowledgments
Author contributions: Dr Tabak had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Dr Shorr: contributed to study concept and design, analysis and interpretation of data, drafting and critical revision of the manuscript for important intellectual content, statistical expertise, and study supervision.
Dr Sun: contributed to study concept and design; acquisition, analysis, and interpretation of data; critical
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Funding/Support: The authors have reported to CHEST that no funding was received for this study.
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